(c) 2015 AIDS United.5AIDS United - Blog RSS Feed - Budget and AppropriationsList of the Latest Blogshttp://aidsunited.org/RssFeedGen.aspx?rss=blog&catid=89Guest Blog: "I Hear Stories that Make My Heart Ache"<a href="http://blog.aidsunited.org/2013/10/guest-blog-i-hear-stories-that-make-my-heart-ache/photo-jason/" rel="attachment wp-att-3385"><img alt="" src="/data/images/Site_18/photo-Jason.gif" class="wp-image-3385 alignleft" style="float: left; margin: 5px; border-width: 1px; border-style: solid;" /></a><em>By Jason Cianciotto, Director of Public Policy,&nbsp;GMHC</em>
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What could our movement to end the HIV epidemic accomplish with $24 billion?<br />
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According to an estimate from the financial services company, Standard and Poors (S&amp;P), that is what the government shutdown cost the U.S. economy. The&nbsp;same political leaders heralding austerity as critical to our nation&rsquo;s future facilitated shenanigans that cost nearly 30% of the $85 billion cut by&nbsp;sequestration this year.<br />
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This is why I woke up Thursday happy the shutdown ended but even angrier. Amidst this political theater, the real-world affects of federal funding cuts&nbsp;have received little attention. This is especially the case for people living with HIV/AIDS.<br />
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It&rsquo;s time for that to change.<br />
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Earlier this week CNN shed light on the consequences of sequestration with a video (<a href="http://money.cnn.com/video/news/2013/10/15/n-non-profit-hiv-aids-sequester-budget-cuts.cnnmoney">http://money.cnn.com/video/news/2013/10/15/n-non-profit-hiv-aids-sequester-budget-cuts.cnnmoney</a>) featuring how cuts have affected programs and services at GMHC. The list is long and depressing: Food pantry bags cut 47%; substance abuse counseling&nbsp;sessions cut 20%; mental health counseling sessions cut 10%; 500 hours of legal counseling services cut; multiple layoffs; a furlough of the entire agency&nbsp;for 1 week; and much more.<br />
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Of course, our real focus should be on how these cuts affect the people who come to us for lifesaving services every day. When I spend time with them I&nbsp;hear stories that make my heart ache. One was shocked to learn that he could no longer receive additional portions from our hot meals program, the only&nbsp;nutritious meal he is able to get per day to help mediate the side effects of his medication. Another became distraught after learning that there was now a&nbsp;one-month waiting list to access individual mental health counseling.<br />
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As GMHC&rsquo;s interim CEO Janet Weinberg shared in the CNN video, it&rsquo;s not like there are other organizations with increased capacity to whom we can refer&nbsp;people in need. These cuts have caused every organization to bleed.<br />
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Just a few days before the shutdown, I joined several colleagues from the AIDS United Public Policy Committee for a Congressional visit day focused on the&nbsp;effects of the sequester. We met with several staffers of Members of Congress, including those representing our respectivehome states, Congresswomen&nbsp;Pelosi&rsquo;s office, and the Health Legislative Aids for House Speaker John Boehner. Our visits with allies produced a unanimous message to bring home: We must&nbsp;actively pursue media outlets and allies to educate the public and lift the voices of people who oppose these draconian federal funding cuts.<br />
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Now that the shutdown drama is over, it&rsquo;s urgent that we re-focus on sharing these stories. The stigma and fear still connected to HIV means that we have&nbsp;to find ways to both empower those willing to share publicly and protect those in need by being their voice when meeting with political leaders and the&nbsp;media.<br />
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We also must acknowledge that it will be extremely challenging for our allies in Congress sitting on the new super committee to roll back the sequester. We&nbsp;know that conservatives are already fighting to reduce the cuts to defense programs in sequester phase 2. They will not be as generous to the&nbsp;non-defense-discretionary programs that provide food, housing, and life-saving medication to people living with HIV/AIDS.<br />
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Despite these challenges, I still fundamentally believe that we can successfully restore federal support for the fight to end the HIV epidemic. We need to&nbsp;leverage public backlash against those responsible for the shutdown and debt ceiling scare to move political leaders to the center and support candidates&nbsp;in the mid-term election who understand our collective social and moral responsibility to care for each other and provide for our nation&rsquo;s health.<br />
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AIDS United provides a critical structure for us to combine our time, talent, passion, and stories to call for policy change as a strong and unified lobby.<br />
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<em>GMHC is a member organization of AIDS United's <a href="policy.aidsunited.org" target="_blank">Public Policy Committee (PPC)</a></em> <br/><i><a href='http://www.aidsunited.org/blog/?id=81'>Click Here For More Information</a></i><br/><hr />Budget and Appropriationshttp://www.aidsunited.org/blog/?id=81http://www.aidsunited.org/blog/?id=81rbanaszak@aidsunited.org(Robert Banaszak)Fri, 18 Oct 2013 00:00:00 GMTPresident Obama?s Fiscal Year 2014 Budget Request Continues Focus on HIV Domestic Programs<a href="http://blog.aidsunited.org/2012/04/hiv-activism-refusing-to-remain-silent-for-30-years/ronald-johnson-web2-2/" rel="attachment wp-att-2437"><img alt="" src="/data/images/Site_18/ronaldNew.jpg" class="alignright size-full wp-image-2437" style="float: left; margin: 5px; border-width: 1px; border-style: solid;" /></a><em>By Ronald Johnson, Vice President of Policy and Advocacy, AIDS United</em>
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On Wednesday, President Obama released his budget request for Fiscal Year (FY) 2014. The budget calls for total spending of nearly $3.8 trillion. The budget proposal reflects the President&rsquo;s continued support for domestic HIV/AIDS programs and the ultimate goal of achieving an AIDS-free generation. Funding levels for the majority of the HIV domestic programs are increased or sustained at FY 2012 levels. The President&rsquo;s budget calls for replacing the automatic spending cuts, known as sequestration, through a more balanced mix of spending cuts and new revenue. This would restore many of the spending cuts made in the current year (FY 2013) as a result of sequestration. AIDS United policy staff has quickly reviewed the President&rsquo;s FY 2014 budget request for domestic HIV and public health funding for the year beginning October 1, 2013 &ndash; September 30, 2014. Further analysis will come later when more detailed information is released. Due to the late decisions on the final FY13 appropriations, the President&rsquo;s FY14 budget proposal is compared to FY12 funding levels.
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The President&rsquo;s budget increases discretionary funding for the Department of Health and Human Services (HHS) to a total of $80.1 billion (up $3.4 million over FY12). Much of the increased funding is targeted for implementation of the Affordable Care Act (ACA). One ACA change called for in the budget is a delay of one year of the phased reduction of the Disproportionate Share Hospital (DSH) payments. DSH payments help hospitals defray the costs of care for uninsured low-income patients. The delay in reducing the DSH payments would help hospitals in states that will not have accepted Medicaid expansion by Jan. 1, 2014. The budget proposal cuts the base discretionary budget authority for the Centers for Disease Control and Prevention (CDC) by $432 million. The budget calls for transferring $755 million from the ACA&rsquo;s Prevention and Public Health Fund to support some of the core CDC programs. With other transfers, total funding for CDC would rise to $11.3 billion, $71 million over FY12 funding. The FY14 Budget includes $9 billion for the Health Resources and Services Administration (HRSA), a net increase of $841 million above the FY 2012 enacted level. The Substance Abuse and Mental Health Services Administration (SAMHSA) received an increase of $4 million over FY12 in the request for a total of $3.6 billion in FY14. The National Institutes of Health FY13 budget is $31.3 billion, an increase of $471 million over FY12.
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We must acknowledge that we continue to be in a very difficult budget environment with the economic recovery slow and the sequester currently in place for FY13 and the next eight years. Below is a breakdown of major accounts. As additional back-up documents and fact sheets become available, we will provide further analysis of the President&rsquo;s budget and the outlook going forward.
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<strong>Centers for Disease Control and Prevention &ndash; National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention</strong>
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President Obama&rsquo;s Fiscal Year 2014 budget request for the domestic HIV portfolio continues to show his commitment to implementation of the National HIV/AIDS Strategy (NHAS) by prioritizing HIV funding. The CDC<strong> </strong>National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention receives an increase of nearly $14 million, including $182,000 for Health Department Prevention. The budget request calls for a transfer of $40 million from less effective programs to create a new initiative to improve linkage to care for individuals newly diagnosed with HIV. $40 million of funding will be redirected for national programs to identify and reach high risk populations to link and retain them in care. The budget calls for essentially level funding at $32.4 million for the Division for Adolescent and School Health (DASH); a small increase of $128,000 for Viral Hepatitis; and basically level funding of $161.7 million for Sexually Transmitted Infections (STIs). Funding for TB prevention is increased by $366,000. HIV programs do not receive any funding from the Prevention and Public Health Funding in FY14. Dr. Tom Frieden, Director of the CDC, continues to say that HIV is a winnable battle for the CDC. The commitment to achieving the goals of the National HIV/AIDS Strategy (NHAS) is evident by the focus that the CDC has put on HIV prevention funding and the importance of linkage and retention in care. The CDC has also increased the HIV surveillance budget by $10 million.
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<strong>HRSA -- Ryan White Program</strong>
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The $20 million increase to the Ryan White Program also shows commitment to the National HIV/AIDS Strategy (NHAS). The increase also includes the President&rsquo;s World AIDS Day 2011 funding in the base of $50 million (AIDS Drug Assistance Program [ADAP] and Part C funding by $35 million and $15 million respectively) that was transferred in FY12, but not included in the current Continuing Resolution (CR) funding of the government now for the balance of FY13. President Obama&rsquo;s FY14 request builds on those two programs with an additional $10 million for Part C and $10 million for ADAP to ensure access to treatment and essential medicine for HIV-positive individuals who are eligible for the Ryan White Program. The rest of the Ryan White Program was flat-funded.
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<strong>Syringe Exchange Programs</strong>
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AIDS United is pleased that President Obama and the Administration included a provision in the FY14 budget that would allow local communities to use federal funds for the purpose of syringe exchange programs.
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<strong>Other HHS Programs</strong>
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The President&rsquo;s budget includes $327 million for Title X, demonstrating the commitment to family planning programs and reproductive and preventive health services, as well as an additional $104.6 million for the Teen Pregnancy Prevention Initiative. The budget &ldquo;zeros out&rdquo; the current $5 million for competitive abstinence-only education grants. The budget does fund Title V abstinence-only at $37 million.
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<strong>Housing and Urban Development &ndash; Housing Opportunities for Persons with AIDS (HOPWA)</strong>
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The National AIDS Housing Coalition (NAHC) has produced policy papers demonstrating the connection between the need for affordable housing and HIV prevention. It is also well documented that housing sustains HIV-positive individuals in care and treatment. There is some confusion over the HOPWA allocation. There are two different budget numbers in two different places in the budget. The Housing and Urban Development Budget overview says HOPWA received $332 million in FY 14, but in the budget appendix it says HOPWA receives $330 million. The HOPWA budget report language also includes a request to modernize the way the HOPWA formula is allocated by moving from the number of AIDS cases to include the number of HIV cases. This shift will require Congress to change the current law; AIDS United is working with NAHC and other organizations to move this forward. AIDS United is investigating this funding discrepancy with the Administration and will report back once we receive clarification.
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<strong>Corporation for National and Community Service</strong>
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President Obama included a $4 million increase for the Social Innovation Fund (SIF) to $49 million and a $5 million increase for the AmeriCorps State and National programs to $346 million. AIDS United has both a SIF grant and an AmeriCorps grant with a focus on HIV and AIDS that funds local access to care programs and the work of AmeriCorps members on HIV throughout the United States. The SIF grant must be matched by our organization and by the grantees on the local level, thus leveraging $2 additional dollars for each $1 federal dollar invested. Often the individuals who serve in AmeriCorps in the HIV arena remain involved in HIV policy, care, treatment, or research for their careers. This is an important pipeline to new HIV workforce members as much of the HIV workforce begins to retire.
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<strong>Veterans Affairs</strong>
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The Department of Veterans Affairs has increased its HIV budget for prevention, care, and treatment of HIV-positive veterans by 16% to $1.1 billion in funding.
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<strong>Department of Justice</strong>
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The Department of Justice will increase its HIV budget by 7.4% to ensure they have additional resources to enforce the laws against stigma and discrimination of HIV-positive individuals.
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<strong>Wrap up</strong>
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President Obama&rsquo;s HIV domestic FY14 budget request is an increase of $1.2 billion over FY12 from $27.8 billion to $29 billion. Unusually, his budget is the last to be released in the FY14 process for funding this year, as both houses of Congress have already passed FY14 Budget Resolutions. Although coming last, the President&rsquo;s budget lays out his priorities for the year to Congress. There are reports that the House and Senate Budget Committee Chairs are working to organize a conference committee to reconcile the two budgets. Prospects for a joint budget resolution are considered slight, although House Budget Committee Chair Paul Ryan (R-WI) gave hopeful comments in an interview on Thursday. The House and the Senate appropriations subcommittees will begin the process of hearing from the department secretaries about their priorities in the President&rsquo;s budget as the appropriations process begins. We will continue to advocate with Congress and the Administration for the highest possible funding amount for the HIV domestic portfolio and keep you informed along the process.
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(Information is gathered from the FY 2014 Budget, appendices, and an off the record call with the Office of National AIDS Policy.)
</p> <br/><i><a href='http://www.aidsunited.org/blog/?id=95'>Click Here For More Information</a></i><br/><hr />Budget and Appropriationshttp://www.aidsunited.org/blog/?id=95http://www.aidsunited.org/blog/?id=95rbanaszak@aidsunited.org(Robert Banaszak)Fri, 12 Apr 2013 00:00:00 GMTWhat's Missing from the Budget Discussions?<a href="http://blog.aidsunited.org/2013/10/whats-missing-from-the-budget-discussions/donna_crews_2013_web/" rel="attachment wp-att-3370"><img alt="" src="/data/images/Site_18/DonnaNew.jpg" class="size-full wp-image-3370 alignleft" style="float: left; margin: 5px; border-width: 1px; border-style: solid;" /></a><em>by Donna Crews, Director of Government Affair</em>s
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There sure is a lot of conversation going on in Washington these days.&nbsp; Government shutdown.&nbsp; Economic shutdown. Repeal of delay of the Affordable Care Act.&nbsp; A major topic of discussion seems to be getting lost in this mix, though: <em>avoiding additional sequestration cuts come January 2014 if the Budget Control Act law is not revised</em>.&nbsp; We at AIDS United encourage our colleagues to continue to contact Congress to eliminate sequestration with a balanced approach to federal deficit reduction (federal cuts and revenue increases), to reopen the government, and avoid a federal default. The total spending amount ($986 Billion) being used in the proposed short-term Continuing Resolution (CR) for the discretionary portion of the bill assumes that sequestration continues. Continuing to use that total number, without repealing the sequester will trigger another round of automatic cuts in January. Sequestration must be repealed to ensure non-defense discretionary programs have the necessary funding to meet the growing needs in public health, education, and nutrition programs.<br />
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Last week, Minority Leader Nancy Pelosi said at a press conference after a meeting of the four leaders at the White House, &ldquo;We&rsquo;ll take your number to keep government open. Give us a chance to vote for it.&rdquo;&nbsp; However, AIDS United believes that the spending total should only be used for the short term CR.&nbsp; The cuts have already cost way too much for the community-based member organizations of AIDS United&rsquo;s Public Policy Committee (PPC). Congress must restore funding by utilizing the higher Senate number of $1.058 trillion for the long-term solution to Fiscal Year 2014 and replacing sequestration.&nbsp; Some of our PPC member agencies have seen anywhere from five to 15 layoffs -- including both medical doctors and lawyers.&nbsp; Some have not filled as many as eight positions lost in attrition; are experiencing anywhere from 30 to 100 increased caseloads for case managers; and having to make drastic cuts to hot meal availability.&nbsp; Waiting lists have been implemented for AIDS Drug Assistance Program (ADAP) medication and for medical treatment slots after an HIV positive initial diagnosis.&nbsp; As one of our PPC members, Carole Treston of the Association of Nurses in AIDS Care (ANAC) stated, &ldquo;A waiting list for care is not just an inconvenience; it is a critical time to engage a person in treatment.&rdquo;&nbsp; If that patient have to wait six weeks for an appointment it could diminish &nbsp;motivation to engage in care and further deteriorate their health and the HIV status of his or her partner --&nbsp; and possibly their community.<br />
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The impact of the sequester on HIV prevention programs are just as severe.&nbsp; One of our PPC members closed their HIV prevention center serving men who have sex with men age 13 to 35, one of the populations most impacted by HIV. &nbsp;While in one of our jurisdictions the cuts from the Centers for Disease Control and Prevention (CDC) were absorbed by the state, enabling their prevention programs to continue unscathed, the &nbsp;majority of our PPC member organizations have been faced with dire prevention cuts, forcing reduction in HIV testing and prevention messages to the high-risk HIV-negative population.<br />
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HIV-focused trainings and workforce development have also been cut by more than ten percent due to rescissions and sequestration, just when the healthcare workforce -- which needs HIV training -- will increase with the expansion of the Affordable Care Act. &nbsp;It is more important than ever to increase our training capacity as more healthcare professionals will interact with HIV-positive individuals across the healthcare spectrum.<br />
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At a time when we have the scientific prevention and treatment tools to begin to end the AIDS epidemic in the United States, it would be immoral&nbsp;to allow funding cuts due to sequestration to divert us from this worthy mission.&nbsp; Congress must find a balanced solution to end the stalemate and &ndash; permanently eliminate the sequester; reopen the government; avoid an economic shutdown.&nbsp; It is too important to the health and well-being of our nation.<br /> <br/><i><a href='http://www.aidsunited.org/blog/?id=82'>Click Here For More Information</a></i><br/><hr />Budget and Appropriationshttp://www.aidsunited.org/blog/?id=82http://www.aidsunited.org/blog/?id=82rbanaszak@aidsunited.org(Robert Banaszak)Fri, 11 Oct 2013 00:00:00 GMT